Type 2 diabetes is a major public health concern, particularly in older adults. There are major gaps in our knowledge about diabetes in the elderly. In older adults, there is controversy regarding the total burden of risk associated with diabetes, optimal treatment targets, and how best to reduce cardiovascular risk and prevent cognitive and physical impairment. Novel biomarkers of diabetes and cardiovascular disease reflect the summation of acute and chronic morbidity and may have utility for informing treatment decisions but they have not been rigorously evaluated in older adults in the community. To address these issues we need junior patient-oriented investigators who will need rigorous training and mentorship in the areas of clinical epidemiology, translational research methods, and the conduct of large clinical studies including randomized clinical trials. The candidate, Elizabeth Selvin, PhD, MPH, has devoted her career to the study of the clinical epidemiology of type 2diabetes and the mentorship of trainees in this field. This midcareer award will protect the time of the candidate for research and mentoring. The goals of the project are to characterize diabetes incidence and progression in older adults, evaluate diabetes awareness and barriers to self-care and treatment adherence, and to examine the prognostic value of novel biomarkers for risk stratification. We will also evaluate the comparative response of traditional and novel cardiometabolic biomarkers to a glucose-lowering intervention in a randomized clinical trial of persons with type 2 diabetes. These projects will provide a rich substrate for training and new research opportunities for mentees. Dr. Selvin has a strong track record of success in the field and in mentoring junior scientists. With support from this K24, Dr. Selvin will be able to expand her mentorship activities, strengthen her research portfolio, and recruit and train the next generation of leaders in the field.